INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE最新文献

{"title":"Palliative care and human rights: the right to access thereto in terms of reform","authors":"I. Senyuta","doi":"10.15574/ijrpm.2023.8.67","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.67","url":null,"abstract":"The peculiarities of exercising the right to access to palliative care (PC) in the context of medical reform have been revealed. Numerous legislative acts have been analyzed and regulatory dissonance has been revealed, which has a negative impact on the peculiarities of the enjoyment of the rights by palliative patients. Attention has been drawn to the fact that PC is not always free, which follows from the analysis of Part 2 of Art. 35-4 of the Law of Ukraine «Fundamentals of the legislation of Ukraine on health care», and only when referring. The Fundamentals clearly regulate the conditions under which PC can be free of charge: 1) in the presence of a referral to a health care institution in which the patient was provided with secondary or tertiary care; 2) an agreement shall be entered into with the referring health care institution of the National Health Service of Ukraine. However, the List of Primary Care Services Annex № 1 to the Primary Care Procedure states that a primary care physician has the right to refer patients in accordance with medical indications for PC to an extent that does not fall beyond primary care. It has been suggested to make changes to the following legislative provisions: 1) Art. 35-4 of the Fundamentals: patients should be entitled to free PC if they have a referral from a primary care physician; 2) Art. 35-4 of the Fundamentals and the Procedure for referring patients to health care institutions and individuals-entrepreneurs who in the manner prescribed by law have received a license to conduct business in medical practice and provide medical care of the appropriate type, approved by the Order of the Ministry of Health of Ukraine from 28.02.2020 № 586 to secure the right to receive free PC without referral. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131374599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term consequences of COVID-19 (review)","authors":"E. Rekalova","doi":"10.15574/ijrpm.2023.8.100","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.100","url":null,"abstract":"COVID-19 is a new especial coronavirus infection that differs from other seasonal respiratory viral infections and can cause damage to many organs and body systems with long-term consequences. In typical cases, the acute period of the disease lasts up to 2 weeks, the recovery period increases to 6 weeks in 35% of patients, and it is observed for months in some patients. Respiratory symptoms (in >50% of patients), 35% - cardiac and 13% - neuropsychiatric symptoms are the most common after COVID-19. The main factors in the pathogenesis of COVID-19 are: block of ACE2 receptors by coronavirus; inadequate response of the immune system to infection (“cytokine storm”) with macrophage hyperactivity syndrome and simultaneous suppression of key parts of the immune system; the development of vasculitis with hypercoagulability and damage to many organs (extrapulmonary systemic hyperinflammation syndrome) with endothelial dysfunction, which may be an important factor in the severity and duration of COVID-19 symptoms. Organizing pneumonia with impaired diffusion of gases is the most common lung injury after COVID-19. Up to 30% of hospitalized patients show signs of myocardial damage. Often pathology of the central nervous system is observed due to potential direct and indirect mechanisms of damage, kidney pathology is too. SARS-CoV-2 may be a trigger for Kawasaki disease. The difficulty of further monitoring of patients with long-term consequences of COVID-19 is due to the need for specialists from various medical specialties and a multidisciplinary organization that would adequately meet today's needs. The long-term effects of COVID-19 continue to be studied. No conflict of interests was declared by the author.","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124429200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodical approaches to determining the influence of the infrastructure of the metropolitan healthcare system on the availability of palliative and hospice medical care","authors":"O. Korniychuk","doi":"10.15574/ijrpm.2023.8.37","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.37","url":null,"abstract":"The essence of the sphere of health care of metropolises is revealed and methodical approaches to determining the influence of its infrastructure on the availability of palliative and hospice medical care are substantiated. No conflict of interests was declared by the author.","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134145492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functions of the family doctor in providing palliative care at the outpatient level","authors":"O.P. Bratsiun","doi":"10.15574/ijrpm.2023.8.98","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.98","url":null,"abstract":"An analysis of the legislative regulation of the functions of a family doctor when providing palliative care at the outpatient level, identification of obstacles and ways to improve care. No conflict of interests was declared by the author.","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129821703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The model of paediatric palliative care organization","authors":"O. Detsyk, R. Melnyk, Zhanna M Zolotarova, Z. Tsikhon, R.E. Kovalchuk","doi":"10.15574/ijrpm.2023.8.96","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.96","url":null,"abstract":"Purpose - to substantiate and develop a functional and organizational model to improve the paediatric palliative care. Materials and methods. It was conducted surveys of 372 relatives of seriously ill children and 578 medical workers in Ivano-Frankivsk region. Results. The inability of the existing organizational forms of children’s palliative care to meet the medical and non-medical needs of seriously ill children and their families has been established. The functional and organizational model of improving the paediatric palliative care is offered. The innovations of the model were: the department of organizational-methodical and consultative care at the regional center of medical rehabilitation and palliative care for children; register of children in need of palliative care; individual program of palliative care for a child. The results of peer review demonstrated the feasibility and predicted efficiency of the model. Conclusions. To recommend the proposed functional and organizational model of improving the paediatric palliative care for implementation in the practice of health care facilities in Ukraine. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133912456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The right to palliative assistance: experience of project implementation","authors":"O. Soroka, U.V. Khomut, N. Fedosenko","doi":"10.15574/ijrpm.2023.8.71","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.71","url":null,"abstract":"The key elements of medical and social care for palliative care patients should be the educational component such as information campaigns and cultural projects, which explain that palliative care is not waiting for death, but a dignified and organized life of the patient and his relatives. Ivano-Frankivsk National Medical University has joined to different projects to support vulnerable groups. In particular, with the financial support of the Public Health program initiative of the International Renaissance Foundation, the university has been implementing measures aimed at social support of children treated in the oncohematology department of Ivano-Frankivsk Regional Children's Clinical Hospital and their families for four years. These children receive high-dose chemotherapy, the procedure of which is long, they do not leave the department for many months, and therefore in addition to treatment they desperately need communication, interesting games, smiles, sincere prayer. At the same time, members of their families need to be able to take a «social break» to watch a movie, visit a theater or swimming pool, feel psychological and legal support, learn to relieve stress and anxiety, counteract stress, not be confined to problems. The quality of life of such people can be greatly improved when they try to see something positive in each day. No conflict of interests was declared by the authors.","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125918953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organizational forms of medical personnel education in paliative care","authors":"H. Ersteniuk, O. Detsyk, Zhanna M Zolotarova, N. Koltsova","doi":"10.15574/ijrpm.2023.8.52","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.52","url":null,"abstract":"Purpose - to study modern views, advanced world and national experience in training medical personnel for palliative care. Materials and methods. Recommendations of international organizations, domestic regulations on palliative care, curricula of medical universities and colleges. Results. It is established that the definition of «Palliative Care» and the levels of its provision, regulated by the current legislation of Ukraine, do not correspond to modern international approaches. The National curricula on palliative care developed by us on the principle of vertical integration and approved by the Ministry of Health in 2014, nowadays, in the era of transition to full autonomy of universities, is outdated. There is no medical specialty «palliative care» in Ukraine. Medical specialists can acquire knowledge and skills in palliative care only within the framework of their continuous professional development at the postgraduate level. According to an EAPC White Paper on Palliative Care Education, the three-level system of medical education based on core competencies and core constituents of palliative care is offer. Conclusions. The system of medical education in Ukraine requires correction in order to acquirement core competencies of palliative care by all medical workers. No conflict of interests was declared by the authors.","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124483114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric syndromes in palliative care for elderly patients","authors":"M. G. Akhaladze, L. Yena","doi":"10.15574/ijrpm.2023.8.92","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.92","url":null,"abstract":"","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121376863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics and safety culture in medical practice","authors":"A. Serdyuk, M. Rygan, Yu.M. Skaletsky","doi":"10.15574/ijrpm.2023.8.138","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.138","url":null,"abstract":"Medical practice is connected with the greatest social values - people's health and life. Its subjects and objects are people with numerous social and biological differences and characteristics. It is obvious that under such circumstances it is impossible to normalize all situations of this practice. Therefore, this involves the wide application of moral laws in health care, supplementing the mechanisms of legal regulation of the relationship between the medical worker and the patient with the norms of medical ethics and deontology. That is why none of the professional communities has at the world, regional and national levels so many conventions, codes, declarations, oaths of a moral and ethical plan, which are an integral part of the regulatory and legal framework of medicine. But ethics and law are not identical. Quite often ethics declare standards of behavior higher than the law. There are known cases where ethics require that doctors not obey laws that require unethical behavior (WMA, 2009). Medical ethics puts the patient and his safety above other criteria for the quality of medical care, above the interests of medical workers. None of these moral and ethical documents bypasses the issue of patient safety, starting with the Hippocratic one: \"refraining from causing any harm\" and ending with the Code of Ethics of a doctor of Ukraine, which emphasizes that \"a doctor must carefully analyze the mistakes made and discuss them with colleagues and guidance for the prevention of similar cases in the clinical practice of other doctors.\" Patient safety is considered an ethical imperative (Vicki D. Lachman, 2007). This is consistent with the concept of safety culture developed by the IAEA after the accident at the Chernobyl nuclear power plant (IAEA, 1991) to prevent emergency situations in the nuclear power sector. The concept of safety culture is considered as a mechanism for identifying hidden safety deficits and puts its level above the requirements of legislation and regulatory bodies (ILO, 2001). The World Health Organization declared its commitment to safety culture principles in 2005 and called on national health care systems to follow suit. In a recent document, the Global Alliance for Patient Safety (HURST, Samia, et al., 2013) emphasizes the need to consider ethical issues in patient safety research. Considering the above, the concept of safety culture, based on the principles of medical ethics, is at the same time its section in the part related to the formation of a safe hospital environment. Today, many countries have successful experience of using safety culture in medicine, and using it and developing it is an urgent task of the domestic medical community. No conflict of interests was declared by the authors.","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122588014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Legal status of palliative and hospice care providers","authors":"N. Kniazevych","doi":"10.15574/ijrpm.2023.8.69","DOIUrl":"https://doi.org/10.15574/ijrpm.2023.8.69","url":null,"abstract":"The paper examines the current legal status of palliative and hospice medicine providers. The latest changes in Ukrainian legislation regulating issues in this area are considered. The main advantages and disadvantages of the regulatory framework are identified. The problems of training and training of medical specialists in palliative medicine are analyzed. The influence of the financial factor on the possibility of providing palliative care by medical professionals in accordance with the requirements of current legislation is studied. The problem of functioning of Primary, general and specialized palliative medicine in Ukraine in accordance with the laws regulating it is investigated. The issues of determining the composition and powers of multidisciplinary teams and their responsibilities are analyzed. Recommendations are given for solving these problems. No conflict of interests was declared by the author.","PeriodicalId":397576,"journal":{"name":"INTERNATIONAL JOURNAL REHABILITATION AND PALLIATIVE MEDICINE","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122466583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}